Developmental services: Policy directives for application

Under the authority of the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008

For adult developmental services

Introduction

Policy directives

Application Entities shall comply with all policy Directives in accordance with the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008.

This document sets out the terms of these Directives.

The Director of Community and Developmental Services will review the Policy Directives for Application Entities annually and will issue amended Directives, if any, on July 1 each year.

Application Entities shall be primary contact points for general information about all relevant community-based services available to persons with developmental disabilities.

Application Entities shall provide a single point of access for persons with developmental disabilities to Ministry-funded adult developmental services and supports in Ontario in accordance with the Act. These developmental services and supports are:

• residential services and supports
• activities of daily living services and supports
• community participation services and supports
• caregiver respite services and supports
• professional and specialized services; and
• person-directed planning services and supports

The Application Entity shall complete the Application Package with each eligible applicant as a required step to informing individual service and support planning, and will facilitate referrals to Ministry-funded adult developmental services and supports where needed, and available.

The Application Package comprises the Application for Developmental Services and Supports (ADSS) and the Supports Intensity Scale® (SIS®).

1.0 Provision of information

Purpose

The purpose of this policy directive is to ensure that Application Entities provide appropriate information and quality customer service to the public in a provincially-consistent manner.

Policy

The Application Entity shall be the primary contact point for public inquiries about all relevant community-based services available in Ontario to persons with developmental disabilities – this information shall be clear and transparent, relevant, responsive, up-to-date, and shall be provided to the public, including persons with developmental disabilities and/or their representatives of choice, in compliance with all applicable legislation.

Directive

When an Application Entity is asked to provide information about adult developmental services and supports in Ontario, the Application Entity shall provide general information on:

• all relevant community-based services^{footnote 1[1]} available to persons with developmental disabilities including Ministry of Community and Social Services (Ministry)-funded adult developmental services and supports^{footnote 2[2]} in accordance with the Act

• the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008, including:
  • the process for applying for Ministry-funded adult developmental services and supports; and
  • where applicable, the choice available to eligible applicants to receive direct funding to purchase adult developmental services and supports, or to access adult developmental services and supports through service agencies funded by the Ministry.

• how to find information on the French Language Services Act, the Accessibility for Ontarians with Disabilities Act, 2005 and its regulations, and the Human Rights Code in Ontario

• how any member of the public can provide feedback to the Application Entity on its customer service (See Policy Directive 7 – Feedback (Customer Service)

• how applicants can provide feedback to the Ministry on the Application Package  (See Policy Directive 7 – Feedback (Customer Service)

• how persons with developmental disabilities can provide feedback on the services and supports provided by service agencies;

• how the Application Entity will respond to email, mail, in-person, and telephone questions about relevant community-based services and service providers for persons with developmental disabilities; and

• location(s) of Application Entities within the region, and locations of other Application Entities across the province, including contact information and hours of operation for each location.

The Application Entity shall use the 211 Ontario data base as a primary source of information about relevant community-based services and service providers for persons with developmental disabilities, wherever available.

The Application Entity shall receive and respond to information requested by any member of the public, and share standard information on Ministry-funded adult developmental services and supports and other relevant community-based services and service providers for persons with developmental disabilities in any of the following ways, as appropriate:

• in person
• via telephone
• by email
• by mail
• over the internet

In general

The application entity shall:

• establish standard business hours of operation during which staff will respond directly to in-person, telephone, and on-line (e-mail) enquiries;

• establish hours outside of standard business hours of operation both during the week and on weekends, for eligible applicants to participate in scheduled Application Package^{footnote 3[3]} interviews;

• maintain accurate, current information on community resources to encourage and support more participation by persons with developmental disabilities in community life;
• develop and implement protocols for responding to information requests made in-person, by telephone, email, mail, through the Application Entity website, or by other means, in a secure and confidential manner and as set out in a Ministry-approved service plan;

• develop and implement protocols for the provision of standard information, as set out in a Ministry-approved service plan, that includes requirements to:
  • provide standard information in plain language, in hard copy (where applicable), by email or through the website, and by voicemail;
  • review and update of standard information annually, and where information comes from an outside source (not directly from the Application Entity), put protocols in place to update information on a regular basis; and
  • include clearly visible, effective and revision dates on all forms, protocols, and in published website content.

• comply with all applicable legislation, which may include:
  • the French Language Services Act, and its regulations
  • accessibility requirements in accordance with the Accessibility for Ontarians with Disabilities Act, 2005, and its regulations
  • the Human Rights Code in Ontario; and
  • the Ministry of Community and Social Services Act

The Application Entity shall include the following specific requirements for telephone, email, website, and in-person information provision in its protocols:

In person

The application entity shall:

• assign responsibility to knowledgeable staff to greet people, respond to in-person requests for information about adult developmental services and supports, and to refer people to additional sources of information and community-based resources as needed;

• provide information specific to the needs of each of the following groups, in a consistent manner to:
  • eligible applicants for adult developmental services and supports in accordance with the Act, and/or representatives of their choice, on the application, prioritization and funding processes, and relevant community-based services available in the community; and
  • potential applicants, and/or representatives of their choice, on the role of the Application Entity, eligibility, the application process, and relevant community-based services available in the community.
• provide access to the above information at least twice a year in an appropriate manner, which may include holding group information sessions; and

• where applicable/possible, use video-conferencing to broadcast information sessions to provide greater access to people who are unable to attend the information sessions in person.

On the telephone

The Application Entity shall:

• provide both a local and toll-free number, and a TTY number, that the public can use to request information; and
   
• have knowledgeable staff available Monday to Friday during standard business hours to answer the telephone.

During business hours, when the telephone cannot be immediately answered, the Application Entity shall:

• provide an alternate number for immediate assistance; and

• activate a standard pre-recorded voicemail message that provides the name of the Application Entity, hours of operation for that day, and if relevant, any walk-in hours.

Outside of business hours or during extended staff absences, the Application Entity shall:

• activate a standard pre-recorded voicemail message that explains the basic functions of the Application Entity and provides telephone numbers for emergency services.

Email

The Application Entity shall:

• where resources do not allow for an immediate response to emails, create a standard auto-reply email that will tell the sender that his/her email has been received and that a response is being prepared.

Website

The application entity shall have its own website (i.e. URL) that will:

• have the same branding as other Application Entities in the province including common core information and language;

• post clearly visible and complete contact information for all office locations within the region which includes names, office addresses, email addresses, local telephone numbers, and toll-free numbers;

• publish business hours of operation for directly responding to inquiries via telephone, on-line (e-mail) and in person;

• publish protocols for service, accessibility and French language services;

• publish protocols for responding to individuals in urgent need of Ministry-funded adult developmental services and supports (See Policy Directive 6 – Individuals in Urgent Need of Support); and

• provide a link to the MCSS website, links to the websites of all other regional Application Entities, and links to other relevant websites; this may include providing website space for service agencies to publicize their services.

2.0 Confirmation of eligibility for ministry-funded adult developmental services and supports

Purpose

The purpose of this policy directive is to outline the procedures used by Application Entities to confirm whether an applicant is eligible for Ministry-funded adult developmental services and supports.

Policy

The Application Entity shall confirm whether an individual is eligible for Ministry-funded adult developmental services and supports in accordance with the Act and the General regulation (O. Reg. 276/10).

Directive

The Application Entity shall review supporting documentation provided by the individual or representative of their choice, to confirm whether an applicant is eligible for ministry funded adult developmental services and supports.

Documents may be originals or photocopies. The Application Entity reserves the right to view the original documents upon request.

Required documentation includes:

• a psychological assessment or report signed by a psychologist or psychological associate registered with the College of Psychologists of Ontario (or equivalent body in another province) that states the individual has a developmental disability in accordance with the Act and Regulation
• proof of age (document displays individual’s name and date of birth)
• proof of Ontario residency (documents displaying the individual’s name, address and citizenship status)

Documents confirming age include but are not limited to a:

• birth or baptismal certificate
• passport
• Ontario health car or
• driver’s licence.

Documents confirming Ontario residency include but are not limited to a:

• Ontario photo card
• rental or lease agreement
• statement of direct deposit for Ontario Disability Support Program
• employer record (pay stub or letter from employer on company letterhead)
• mailed bank account statements (does not include automated teller receipts or bank books) or,
• utility bill or
• proof of Canadian citizenship and/or immigration documents.

Definitions

Under the Act and Regulation, a person has a developmental disability if the person has the prescribed significant limitations in cognitive functioning and adaptive functioning and those limitations:

• originated before the person reached 18 years of age
• are likely to be life-long in nature; and
• affect areas of major life activity, such as personal care, language skills, learning abilities, the capacity to live independently as an adult or any other prescribed activity.

“Adaptive functioning” means a person’s capacity to gain personal independence, based on the person’s ability to learn and apply conceptual, social and practical skills in his or her everyday life.

“Cognitive functioning” means a person’s intellectual capacity, including the capacity to reason, organize, plan, make judgments and identify consequences.

Under the Regulation, a person has significant limitations in cognitive functioning if the person meets one of the following criteria:

• The person has an overall score of two standard deviations below the mean, plus or minus standard error measurement, on a standardized intelligence test; or
• The person has a score of two standard deviations below the mean in two or more subscales on a standardized intelligence test and the person has a history of requiring habilitative support; or
• On the basis of a clinical determination made by a psychologist or a psychological associate, the person demonstrates significant limitations in cognitive functioning and the person has a history of requiring habilitative support.

“Habilitative support” means support where the objective of the support is to enable the person to acquire, retain and improve skills and functioning related to activities of daily living in the areas of self-care, communication and socialization.

“History of requiring habilitative support” means a history of having support needs that are life-long in nature and are due to functional impairment caused by a congenital injury, condition or disease or by an injury, condition or disease acquired prior to age 18.

A person has significant limitations in adaptive functioning if the person has a score of at least two standard deviations below the mean, plus or minus standard error measurement, in at least one of the areas of conceptual skills, social skills or practical skills, as measured on a standardized test of adaptive behaviour.

Note: Individuals who have previously been determined eligible for ministry funded adult developmental services and supports under the Developmental Services Act and are currently receiving supports, or are on a wait list to receive supports, have been deemed to be eligible under sections 42 and 43 of the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008.

In addition, Ontario Regulation 414/12, made under SIPDDA, deems the following groups of people eligible for adult developmental services:

• Adults with a developmental disability who were receiving support under the Passport program on April 1, 2012, or who transitioned from the Special Services at Home program (SSAH) to the Passport program on April 1, 2012
• Adults with a developmental disability who were on the SSAH waitlist as of March 31, 2012
• Children with a developmental disability receiving SSAH who turned 18 before March 31, 2013
• Children with a developmental disability who turned 18 between April 1, 2012 and March 31, 2013 and who were on a waitlist for SSAH before they turned 18; and
• Individuals who applied and were found eligible for adult services and supports under the Developmental Services Act between January 1, 2011 and June 30, 2011 and began to receive support or were placed on a waitlist for support during that time.

These individuals are not required to undergo eligibility confirmation in accordance with the Act and Regulation.

Confirming whether an applicant is eligible

The Application Entity shall use ministry approved decision-making tools to confirm whether an applicant is eligible for ministry funded adult developmental services and supports.

Where an individual’s documentation demonstrates the individual has a developmental disability in accordance with the Act and Regulation, and meets all eligibility criteria, the Application Entity shall confirm the individual’s eligibility for ministry funded adult developmental services and supports.

Where an individual’s documentation indicates the individual does not have a developmental disability or does not meet all eligibility criteria in accordance with the Act and Regulation, the Application Entity shall find the individual ineligible for ministry funded adult developmental services and supports.

Where an individual’s documentation does not provide sufficient information, diagnostic conclusions, or a clear determination by a psychologist or psychological associate that the individual has a developmental disability, the Application Entity cannot confirm the individual’s eligibility for ministry funded adult developmental services and supports. The following procedures are to be followed in these cases:

• If the individual is 18 years of age or older and does not have a psychological assessment or report by a psychologist or psychological associate but the documentation provided indicates the presence of a developmental disability (e.g., school or medical records), the Application Entity will facilitate referral to a ministry funded agency for assessment by a psychologist or psychological associate to determine whether the individual has a developmental disability as defined in the Act and regulation.
• If the individual is 18 years of age or older and the psychological assessment or report by a psychologist or psychological associate provided indicates the presence of a developmental disability but the information in the assessment or report is unclear or insufficient to confirm whether the individual has a developmental disability as defined in the Act and Regulation, the Application Entity shall ask the individual to obtain the required information from the psychologist or psychological associate who prepared the original report. If the individual cannot obtain the information required from the psychologist or psychological associate who completed the assessment, the Application Entity shall forward the individual’s documentation to a Ministry-funded agency to determine whether the individual has a developmental disability as defined in the Act and Regulation.
• Following a review of the individual’s documentation, if the psychologist or psychological associate determines that additional assessment of the individual is required to determine whether the individual has a developmental disability as defined in the Act and Regulation, the psychologist or psychological associate shall advise the Application Entity. The Application Entity shall refer the applicant to a Ministry-funded agency for assessment by a psychologist or psychological associate to determine whether the individual has a developmental disability as defined in the Act and Regulation.

Note: Individuals may also purchase the services of a psychologist or psychological associate at their own expense.

Communicating the decision on eligibility

The Application Entity shall advise the individual, or representative of their choice, in writing whether the individual is eligible for Ministry-funded adult developmental services and supports in accordance with the Act and Regulation, within 20 business days of receipt of all documentation, including receipt of any documentation review or the results of (re)assessment by a psychologist or psychological associate required to confirm eligibility for developmental services and supports.

Recording the eligibility decision

Once eligibility or ineligibility has been confirmed, the Application Entity shall record the decision in the individual’s file. Copies or electronic records/copies of all required documentation shall be retained for individuals who have been confirmed eligible for adult developmental services and supports for a minimum of seven years after the Application Entity has assessed the person’s needs for services and supports (in accordance with the Regulation on Quality Assurance Measures).

3.0 Review process for decisions on eligibility

Purpose

The purpose of this policy directive is to ensure that the process used by Application Entities to review a decision where an individual is deemed ineligible for Ministry-funded adult developmental services and supports adheres to the principles and objectives of equity, fairness, and provincial consistency.

The review process has three goals:

1. To encourage review and resolution of decisions on eligibility at the local level
2. To provide timely resolution of disputes; and
3. To provide a fair, unbiased and user-friendly review process.

This policy directive outlines the review process for individuals who are deemed ineligible for Ministry-funded adult developmental services and supports in accordance with the Act.

Policy

The Application Entity shall use a provincially-consistent review process to verify whether or not all relevant factors were considered in making the decision on eligibility and whether or not the decision rendered is fair, transparent, and consistent with the Act and Regulation.

At no stage of the review process is the accuracy or validity of the individual’s clinical diagnosis to be assessed or evaluated by the Application Entity.

Note: If an individual, and/or representative of their choice, believes that the diagnosis provided by a psychologist or psychological associate does not accurately reflect their level of cognitive and adaptive functioning, they must seek resolution of this issue with the psychologist or psychological associate who completed the psychological assessment/psychological report. Alternatively, the individual or person acting on their behalf may seek the second opinion of a psychologist or psychological associate registered with the College of Psychologists of Ontario and undergo additional diagnostic testing and/or assessment.

Directive

An Application Entity shall use a three-stage approach to review a decision on eligibility that is under dispute.

Stage 1

• An individual requesting Ministry-funded adult developmental services and supports who is deemed ineligible in accordance with the Act may request a review of that decision.

• The individual, and/or representative of their choice, has 25 business days from the date of the letter informing them of their ineligibility to provide the Application Entity with a written request for a review of that decision. The Application Entity may exercise discretion in extending this timeframe in instances where an individual, and/or representative of their choice, is unable to submit the written request as required.

• Stage 1 of the review process will be conducted by the specific Application Entity staff who made the decision on eligibility based on the documents submitted by the individual in question, and the staff supervisor. The Application Entity must complete this stage within 15 business days of receiving the request to review the decision on eligibility.

• At this stage of the review process, the Application Entity shall provide the individual and/or representative of their choice with:
  • a copy of the definition of a person with a developmental disability and eligibility criteria as set out in the Act and Regulation
  • an opportunity to demonstrate that the eligibility criteria set out in the Act and Regulation have not been accurately applied in their case; and
  • an opportunity to provide any additional supporting information and documentation that may have a bearing on the eligibility decision.

• The Application Entity staff and staff supervisor shall:
  • review the individual’s documentation, and any additional information or supporting documentation provided to the Application Entity, to confirm whether or not the individual meets the eligibility criteria in accordance with the Act and Regulation
  • if requested, meet with the individual and/or representative of their choice to discuss the individual’s file and supporting documentation and to explain the eligibility criteria and how the criteria apply to their case; and
  • render a new decision on eligibility, and notify the individual and/or representative of their choice, in writing, of the outcome of the Stage 1 review, within 15 business days.

If the individual and/or representative of their choice disagrees with the outcome of their Stage 1 eligibility decision review by the Application Entity staff and staff supervisor, or believes that he/she was treated unfairly in the process, the individual may request a Stage 2 review.

Stage 2

• Within 10 business days of receiving a decision on their Stage 1 eligibility decision review, the individual and/or representative of their choice may request in writing that the Executive Director of the Application Entity review the individual’s case. The Application Entity must then complete Stage 2 of the eligibility review within 15 business days of receiving the written request.

• The Executive Director (or delegate) of the Application Entity shall:
  • determine if the rules in Stage 1 of the review were observed
  • provide the individual and/or representative of their choice with an opportunity to submit any additional information and supporting documentation that may have a bearing on the review process and original eligibility decision
  • review the individual’s information and supporting documentation to confirm whether or not the individual meets the eligibility criteria set out in the Act and Regulation; and
  • render a decision and notify the individual and/or representative of their choice, in writing, of the decision within 15 business days.

• If the individual and/or representative of their choice disagrees with the outcome of their Stage 2 eligibility decision review by the Executive Director, or believes that he/she was treated unfairly in the process, the individual may request a Stage 3 review.

Stage 3

• Within 10 business days of receiving a decision on their Stage 2 eligibility decision review, the individual and/or representative of their choice may request, in writing, a Stage 3 review by the Executive Director (or delegate) of an Application Entity in another region of the province.
• The Application Entity that conducted the Stage 2 review shall send the written request for a Stage 3 review to the Executive Director (or delegate) of the Application Entity as determined by the individual requesting the review or, if the individual has no preference, by the Application Entity. The Executive Director of the Application Entity who receives this request for review must comply with the request and complete the Stage 3 eligibility review within 15 business days of receiving the written request.
• The Application Entity that has deemed the individual ineligible at Stages 1 and 2 of the eligibility review process shall not participate in the Stage 3 review.
• In the Stage 3 review process, the Executive Director (or delegate) of the Application Entity shall:
  • provide the individual and/or representative of their choice with the opportunity to provide any additional information and supporting documentation that may have a bearing on the review process and decision on eligibility.
  • determine if the rules in Stage 2 of the review were observed
  • review the individual’s information and supporting documentation to confirm whether or not the individual meets the eligibility criteria set out in the Act and Regulation; and
  • render a Stage 3 review decision and notify the Application Entity that conducted the Stage 1 and Stage 2 reviews and the individual and/or representative of their choice of the decision rendered in writing.

The decision of the Stage 3 review is final.

4.0 Assessment of support needs

Purpose

Application Entities shall use a provincially-consistent assessment process for Ministry-funded adult developmental services and supports to:

• improve the quality and responsiveness of Ministry-funded adult developmental services and supports: Using the Application Package, which comprises the Application for Developmental Services and Supports (ADSS) and the Supports Intensity Scale® (SIS®), to collect information on the support needs, priorities and circumstances of eligible applicants, will facilitate accurate assessments and inform the development of individual support plans directed by the needs of eligible applicants

• reduce the burden on persons with developmental disabilities and families: Having a standardized, valid and provincially-consistent assessment process for all Ministry-funded adult developmental services and supports will mean that applicants will not have to repeat their personal history when they apply for developmental services and support;

• improve system fairness and sustainability: Adopting a provincially-consistent approach to needs assessment will support equitable service decisions so that persons with developmental disabilities with similar support needs and in similar circumstances will receive similar adult developmental services and supports, no matter where they live in the province; and

• support better planning: Using a provincially-consistent approach to collect information on the support needs, priorities and circumstances of persons with developmental disabilities will provide valid and reliable information to inform individual service and support planning.  This approach will also provide a basis for conducting accurate, comparative statistical analyses of collected data, to be used for planning at the community and provincial levels (See Policy Directive 8 – Reporting to the Ministry).

Policy

Application Entities shall use a provincially-consistent method to assess the support needs of applicants eligible for Ministry-funded adult developmental services and supports to be provided in accordance with the Act.

Directive

The Application Entity shall use the Application Package, consisting of the Application for Developmental Services and Supports (ADSS) and the Supports Intensity Scale® (SIS®), as the provincially-consistent method to assess the support needs of applicants eligible for Ministry-funded adult developmental services and supports in accordance with the Act.

5.0 Assessor qualifications and service standards for the assessment of support needs

Purpose

The purpose of this policy directive is to ensure provincially-consistent information gathering by Application Entities so that decisions and planning for Ministry-funded adult developmental services and supports are based on accurate information on the needs, priorities and circumstances of persons determined to have developmental disabilities in accordance with the Act.

Policy

Application Entities shall implement a provincially-consistent process for assessing the support needs of applicants eligible for Ministry-funded adult developmental services and supports in accordance with the Act, to be administered by qualified assessors.

Directive

The Application Entity shall assign responsibility to qualified assessors for the administration of the Application Package to collect data on the support needs, priorities and circumstances of persons with developmental disabilities. The Application Package consists of the Application for Developmental Services and Supports (ADSS) and the Supports Intensity Scale® (SIS®).

The Application Entity shall ensure that the Application Package data is collected, stored and maintained accurately and consistently and meets the quality standards required by the Ministry as set out by the assessor training and data quality assurance program.

The Application Entity shall provide for assessors to participate in ongoing Ministry-led assessor training and data quality assurance events, and ensure that they adhere to and maintain the provincially-consistent standard for assessing and reporting support needs as set out in this directive.

• A support needs assessment is valid and complete only when conducted by an assessor who has successfully completed the Ministry's assessor training and data quality assurance program within the last 18 months. 

Required qualifications and competencies for assessors

The Application Entity shall ensure that assessors who administer the Application Package have the following qualifications:

• completed formal education of an undergraduate degree or equivalent, in a field related to human services (such as psychology, sociology, or social work)^{footnote 4[4]}
• a minimum of five years recent experience working directly in the field of developmental services, or equivalent experience working in an occupation related to human services^{footnote 5[5]}
• experience in intake, case management, service coordination, direct support and/or advocacy roles, and
• successfully completed training on the administration of the Application Package through the Ministry’s assessor trainer and data quality assurance program

Assessors shall meet the following ongoing training and experience requirements to ensure that their skills continue to meet the Ministry's standards:

• Successfully complete interviewer reliability reviews through the Ministry’s assessor training and data quality assurance program every 18 months; and
• Frequent and ongoing administration of the Application Package with applicants. As a best practice, full-time assessors should administer at least 36 Application Packages in the 18-month period between each successful completion of the interviewer reliability review through the Ministry's assessor trainer and data quality assurance program.
• Part-time, secondment, and/or contract assessors as a best practice should administer at least two Application Packages during each month of employment with the Application Entity, following successful completion of the interviewer reliability review.
• Assessors who return from a leave of absence greater than four months are required to attend a monitoring session with a trainer before resuming administration of the Application Package.

Assessors should also demonstrate the following competencies:

• Strong interview skills, good active listening ability, comfortable rapport with people of all abilities, and a good sense of when additional inquiry/questioning is required to clarify ambiguity; and
• A person-centred approach to facilitation, ability to focus the discussion on the support needs and priorities of the individual, and ability to identify nuanced differences between the priorities of the individual and those of other care providers.

The Application Entity shall also ensure that assessors who administer the Application Package are independent from direct provision of developmental services (are not employed in a service agency that delivers residential services and supports or community participation services and supports under the authority of the Act).

Service standards for the assessment process (application package administration)

The Application Entity shall establish and maintain the following service standards for assessors to follow in administering the Application Package:

• Information about an applicant may only be collected after the applicant has been informed, and understood the purpose of information collection and sharing in accordance with the Act;
• Administration of the Application Package shall involve two semi-structured interviews held by an assessor^{footnote 6[6]} with the eligible applicant and at least one but no more than four respondents, following the approach described in the assessor training and quality assurance program and the Application Package training manuals;
• A respondent is defined as someone who has known the applicant well for at least the last three months and has had the opportunity to observe the applicant in one or more environments for substantial periods of time.  A respondent also has to be able to understand and answer all questions;
• A respondent can be a parent, sibling, other relative, guardian, direct support staff, work supervisor, teacher, or any other individual who supports, works with, or lives with the applicant being assessed and understands the applicant and his or her specific support needs;
• Every effort should be made by the Application Entity to ensure that the applicant is included and present at both Application Package interviews
• In exceptional circumstances, the applicant may attend an interview in part or the interview can be held with the applicant alone:
  • the applicant may attend an interview in part where the applicant is clearly not benefiting from the interview but wishes to complete an Application Package; or
  • the interview may be held with the applicant alone if the applicant does not have someone who knows them well for at least the last three months and/or the applicant demonstrates a strong preference to represent him/herself.
• Only in exceptional circumstances, or if the applicant requests or requires it, should there be more than 15 business days between the first and second interview
• The Application Entity shall provide background information about the interviews, and the Application Package to the applicant and respondent(s) at least (10) business days before the first interview
• The applicant may complete certain sections of the Application Package before the interview. At the first interview, the assessor will review the applicant's pre-completed sections to confirm that the questions are clearly understood and that the responses are complete
• The interviews will be conducted in person, with all participants meeting at the same location or with all participants participating via video-conference technology
• The assessor must record a valid response for all questions included in the Application Package; and
• The Application Entity shall reassess the support needs of persons with developmental disabilities on the wait list and those in service every five years:
  • Reassessment shall take place at five-year intervals based on the date of the last completed Application Package;
  • The Application Entity shall ensure that assessors adhere to the service standards for administering the Application Package when they conduct reassessments of the support needs of persons with developmental disabilities
  • The reassessment will comprise completing a new Application Package, including a new ADSS and a new SIS®; and
  • If a person with a developmental disability’s support needs or personal circumstances change significantly, the Application Entity shall make arrangements for more immediate reassessment.
• Qualified assessors may administer the Application Package with applicants from the age of sixteen who, with the exception of the age requirement, meet the criteria for Ministry-funded adult developmental services and supports in accordance with the Act.
  • Application Entities may not facilitate referrals for these applicants to Ministry-funded adult developmental services and supports until they are eighteen years of age.

6.0 Individuals in urgent need of support

Purpose

The purpose of this policy directive is to ensure that the Application Entity follows consistent processes with persons with developmental disabilities who urgently need adult developmental services and support.

Policy

The Application Entity shall use a provincially-consistent process to respond to persons in urgent need where there are reasonable grounds to believe, or it is already known, that such persons are eligible for adult developmental services and supports.

Directive

When an individual contacting an Application Entity needs an emergency service response, the Application Entity shall provide information to direct the individual to the most appropriate local emergency service (for example, the police, hospital or local clinic).

When an individual contacting an Application Entity is in urgent need of service, the Application Entity shall initiate the local process for resolving service issues for persons with developmental disabilities (such as urgent response) that may refer the individual to appropriate available, interim support.

Where an individual has not previously completed the confirmation of eligibility process for Ministry-funded adult developmental services and supports, the Application Entity shall follow-up with the individual to complete the eligibility confirmation process in accordance with the Act.

The Application Entity shall complete and/or update the full Application Package for all eligible individuals as soon as possible and no later than twelve (12) months after the date of the initial request for urgent support.

The Application Entity is not to provide any direct care services for individuals with immediate or urgent support needs.

Examples of situations where persons with developmental disabilities may have an urgent need for service include:

• The unpaid primary caregiver (e.g., family member) is unable to continue providing care that is essential to the health and well being of the adult.
• The individual has no residence, or anticipates in the very near future a very real likelihood of having no residence.
• The individual’s support needs have changed to such an extent that their current support arrangement may soon become untenable and their well-being is at risk.

7.0 Feedback process (customer service)

Purpose

The purpose of this policy directive is to ensure that Application Entities have a provincially-consistent process in place to receive feedback about the services that they provide. This process is an important part of providing quality customer service, and supports continuous improvement in service delivery.  This policy directive also requires that Application Entities provide applicants and their representatives of choice with the opportunity to provide confidential feedback to the Ministry about their satisfaction with the Application Package.

As a provider of goods and services, each Application Entity with more than 20 employees was required to establish a feedback process on its customer service by January 1, 2012, to be in compliance with the Accessibility for Ontarians with Disabilities Act, 2005 and O. Reg. 429/07.

This policy directive outlines additional requirements around a feedback process for Application Entities.

Policy

The Application Entity shall establish a feedback process to gather confidential feedback and to address concerns raised in the feedback by applicants, persons previously determined to have developmental disabilities and/or representatives of their choice, staff and volunteers at the Application Entity, and by the general public, about the Application Entity and about its customer service.

Directive

Feedback about Application Entity Services

The Application Entity shall develop and implement policies and procedures for gathering feedback and addressing concerns about its customer service in compliance with the Accessibility for Ontarians with Disabilities Act, 2005 and O. Reg. 429/07.

The Application Entity shall also comply with the policies and procedures set out in O. Reg. 299/10 under the Act on abuse prevention and reporting, and with the Ministry process for reporting serious occurrences when a report is received in this regard. 

The Application Entity shall conduct an annual review and analysis of feedback received and how concerns raised in the feedback were addressed, and evaluate the effectiveness of its policies and procedures on the feedback process for the Board of Directors.

Feedback on the Application Package

The Application Entity shall provide applicants and/or representatives of their choice with the confidential Ministry survey about the Application Package:

• Implementation of this policy directive is based on the use of a Ministry-specified survey tool and a common set of questions

• Anonymous surveys shall be sent directly from the applicant to the administrator of the Ministry’s survey tool (either electronically or in hard copy); and

• Only Ministry Corporate staff shall have access to the anonymous survey results.

8.0 Reporting to the ministry

Purpose

The purpose of this policy directive is to ensure efficient and transparent communication between the Ministry and the Application Entity and to ensure the collection of up-to-date data for the generation of reports that will inform community planning, and MCSS forecasting, performance measurement, and program and policy development.

Policy

The Application Entity shall be responsible for providing the Ministry with quarterly and annual reports that contain data from the assessment process and from MCSS service agencies, as set out in this directive, and additional reports as required by the Ministry.

Directive

The Application Entity shall:

• use the information technology specified by the Ministry for the collection and maintenance of information;
• follow procedures established for the MCSS-specified information technology and in the policy directive for Qualifications and Service Standards for Needs Assessment, to maintain the integrity, consistency and validity of the information collected and to meet reporting requirements;
• prepare quarterly reports based on summary statistics including, but not limited to, the following:
  • Uptake and use of direct funding:
    • Number of direct funding agreements
    • Dollar value of agreements
    • Adult developmental services and supports being purchased, by MCSS detail code; and
    • The proportion of all applicants with direct funding agreements, by MCSS detail code.
  • Adult developmental services and supports inquiries:
    • Number and type of inquiries (including urgent requests).
  • Eligibility:
    • Number of applicants confirmed eligible;
    • Number of applicants deemed ineligible
    • Number of decision review requests;
    • Number of decision review requests resulting in a decision that confirms eligibility; and
    • Number of decision review requests resulting in a decision that upholds the original decision that individual is ineligible.
  • Timing:
    • Average number of business days between initial contact and eligibility confirmation; and
    • Average number of business days between eligibility confirmation and the first Application Package interview.
  • Number of qualified assessors^{footnote 7[7]}:
    • Number of incumbents; and
    • Full Time Employees (FTEs).
  • The Application Package:
    • Exceptional medical and behavioural support needs (SIS®, section 3 raw scores)
    • Number of applicants by SIS®; support needs index (Composite Standard Score)
    • Nature of current request (ADSS section 1, question 1)
    • Current situation of the applicant (ADSS section 1, question 2)
    • Age (ADSS section 1, question 3)
    • Gender (ADSS section 1, question 3)
    • Preferred language for the interview (ADSS section 1, question 9); and
    • Current living situation (ADSS section 2, questions 7).
  • Total number of in-progress Application Packages;
  • Total number of completed Application Packages, and the subtotals for:
    • Eligible applicants who completed their first Application Package who were not previously receiving any Ministry-funded adult developmental services and supports
    • Eligible applicants who completed their first Application Package and who were receiving Ministry-funded adult developmental services and supports; and
    • Persons previously determined to be eligible for Ministry-funded adult developmental services and supports who were reassessed, by age group and type of reassessment (five-year reassessment vs. requested reassessment due to change in needs or circumstances).
  • Access to Ministry-funded adult developmental services and supports:
    • Eligible applicants who were not previously receiving any Ministry-funded adult developmental services and supports, who received adult developmental services and supports by MCSS detail code
    • Eligible applicants who were not previously receiving any Ministry-funded adult developmental services and supports, and did not receive developmental services and supports; and
    • Persons previously determined to have a developmental disability who were requesting additional Ministry-funded adult developmental services and supports who received more, new, or different developmental services and supports, by MCSS detail code.
  • A comparative analysis of adult developmental services and supports obtained by applicants by direct-funding and those obtained through service agencies funded by the Ministry; and
  • An analysis of the changes in individual applicant needs from the administration of the initial Application Package and at five-year reassessment intervals.

Application Entities shall complete these reports every quarter and forward them as a package to the Regional Office for review no later than one month after the end of the fiscal quarter.

The reporting schedule for the quarterly reports and the annual report is as follows:

• Q1 Report Due: July 31 (for April 1 - June 30)
• Q2 Report Due: October 31 (for July 1 – September 30)
• Q3 Report Due: January 31 (for October 1 - December 31); and
• Q4 Report (for January 1 – March 31) and Annual Report Due: April 30.

9.0 Posting letter of compliance or letter of non-compliance

Introduction

The Ministry of Community and Social Services’ (MCSS) Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008 (SIPDDA) provides the legislative framework for ministry-funded adult developmental services in Ontario.  The regulation on quality assurance measures (Ontario Regulation 299/10), made under the Act, and the Policy Directives for Service Agencies and Policy Directives for Application Entities set out further requirements for agencies and application entities (operating as Developmental Services Ontario (DSO).

The ministry conducts compliance inspections of MCSS-funded service agencies and DSOs, to assess whether they meet the requirements outlined in the regulation on quality assurance measures and the policy directives.  During a compliance inspection, the ministry typically reviews records and documentation, policies and procedures, and conducts a site inspection, to evaluate and determine whether service agencies and DSOs are adhering to the requirements that are set out in the regulation on quality assurance measures (Ontario Regulation 299/10), made under SIPDDA, and the policy directives.  At the end of the inspection, ministry staff issue a letter to the agency/DSO that outlines the agency’s/DSO’s compliance status.

The ministry recognizes that people who access developmental services and supports, their families and others who may act on their behalf, and the general public, likely expect that MCSS-funded services and supports are provided in a sufficiently safe environment that seeks to meet the needs of the individual.  There is also an expectation that the agency/DSO is meeting the requirements set out by the ministry.  The ministry acknowledges the need for openness and transparency of information.  Requiring that developmental services agencies and DSO offices provide information on the outcome of a compliance inspection of an agency or DSO is one such way to promote openness and transparency.

Definitions

“ Letter of Compliance” is a letter that is issued by the Ministry of Community and Social Services to a service agency or DSO, following the ministry’s review and evaluation of the service agency’s or DSO’s ability to meet requirements that are outlined in the regulation on quality assurance measures (Ontario Regulation 299/10, made under SIPDDA) and the Policy Directives for Service Agencies or Policy Directives for Application Entities.  The Letter of Compliance summarizes the results of the compliance inspection and confirms that the agency or DSO is in compliance with requirements. 

“ Letter of Non-compliance” is a letter that is issued by the Ministry of Community and Social Services to a service agency or DSO, following the ministry’s review and evaluation of the service agency’s or DSO’s ability to meet requirements that are outlined in the regulation on quality assurance measures (Ontario Regulation 299/10, made under SIPDDA) and the Policy Directives for Service Agencies or Policy Directives for Application Entities.  The Letter of Non-compliance summarizes the results of the compliance inspection, and confirms there are areas of non-compliance and may identify the non-compliances that must be remedied within specified timelines.

Purpose

The purpose of this policy directive is to outline the Ministry of Community and Social Services’ requirements for DSO offices regarding the public posting of the results of a DSO compliance inspection conducted by the ministry.  These requirements aim to promote public access to information about MCSS-funded services and supports and the providers of those services and supports.

The ministry also requires service agencies to publicly post the results of their compliance inspections.

Directive

A DSO shall post a hard/paper copy of the Letter of Compliance that is issued by the ministry following a compliance inspection.  The Letter of Compliance shall be posted at or near the main entrance of the head office of the DSO in a prominent location of that office so that the letter is clearly and easily visible to those who enter.  The Letter of Compliance shall remain posted until the completion of a subsequent compliance inspection.

A DSO shall post a hard/paper copy of the Letter of Non-compliance that is issued by the ministry if the DSO remains in non-compliance post 10 business days of the compliance inspection.  The Letter of Non-compliance shall be posted at or near the main entrance of the head office of the DSO in a prominent location of the office so that the letter is clearly and easily visible to those who enter.  The Letter of Non-compliance shall remain posted until the DSO receives a Letter of Compliance.

A DSO shall ensure that the most recent Letter of Compliance or Letter of Non-compliance is posted within three business days of receipt from the ministry. 

A DSO shall provide information on its current compliance status and the results of its ministry compliance inspection, if requested by any person.

A DSO shall respond to inquiries about the compliance status that may be received (e.g., from an individual with a developmental disability who receives services and supports from the DSO, from a person acting on behalf of the individual who receives services and supports from the DSO, or from the general public). 

For DSOs that are funded by the ministry to provide services at multiple sites/locations, the DSO shall ensure that a copy of the Letter of Compliance or Letter of Non-compliance related to each site is available upon request from the DSO’s head office.  A copy of the letter need not be posted at each site/location owned or operated by the DSO; however, the DSO is expected to respond to any questions about the compliance or non-compliance of any site (e.g., a satellite office).

In addition to posting a hard/paper copy of the Letter of Compliance or Letter of Non-compliance, a DSO is encouraged to post an electronic copy of the Letter on its website, if available, although this is not required.